Hyperechogenic bowel was identified among 55 of 6781 (0.81%) fetuses p
rior to second-trimester genetic amniocentesis. Trisomy 21 was found i
n eight of the 55 (14.5%) fetuses identified with hyperechogenic bowel
compared to 60 of 6726 (0.89%) fetuses with normal bowel echogenicity
(p < 0.001). Hyperechogenic bowel carried a 16-fold greater risk for
Down's syndrome than normal bowel echogenicity (relative risk 16.8, 95
%; confidence intervals 8.2-32.5). Chromosome abnormalities other than
trisomy 21 were found in four additional fetuses with hyperechogenic
bowel (two triploid and one each with 47,XXX; 45,X/47,XXX mosaicisim).
Combining these four cases with the eight fetuses having trisomy 21,
21.8% (12 of 55) of fetuses with hyperechogenic bowel proved to have a
chromosome abnormality. We conclude that hyperechogenic bowel is asso
ciated with chromosome abnormalities, particularly Down's syndrome, wh
en detected during the second trimester.